The Evolution of Physical Activity and Health Research in China: A Bibliometric Analysis of Study Areas and Sex Balance in Authorship.

BACKGROUND: This article evaluates the evolution of physical activity and health research in China through a bibliometric analysis focused on number of publications, study areas, and sex balance in authorship. METHODS: A systematic review was conducted by the Global Observatory for Physical Activity for "physical activity and health" publications between 1950 and 2019. Here, we focus on the 610 Chinese publications identified, defined as those in which data collection took place in China. We assessed the number of publications, classified them into 5 areas (1) surveillance, (2) correlates and determinants, (3) health consequences, (4) interventions, and (5) policy, and analyzed female participation in authorship. RESULTS: The first Chinese publication identified in the review was in 1990. Since, the average number of physical activity and health publications increased from one per year in the 1990s to 7.6 per year in the 2000s, and to 47 per year in the 2010s. Most publications focused on the correlates and determinants (38.7%) and the health consequences of physical activity (35.9%). Physical activity policy accounted for 2.3% of the publications. In the 1990s, 64% of the publications included at least one female author; this proportion increased to 90% in the 2010s. CONCLUSION: Despite a slow start, China's research on physical activity and health has grown rapidly since 2000. The distribution of publications by study areas and female participation in authorship is similar to that observed globally, with fewer publications focused on interventions and policy as compared with other topics.

Gender Differences in Physical Activity and Health-Related Authorships Between 1950 and 2019.

BACKGROUND: The objective of this study was to investigate gender differences in authorship in physical activity and health research. METHODS: A bibliometric study including 23,399 articles from 105 countries was conducted to estimate the participation of female researchers in physical activity publications from 1950 to 2019. The frequency of female researchers was analyzed and classified by first and last authors and the overall percentage of female authors by region and country. RESULTS: The proportion of female first authors increased from <10% in the 50s and 80s to 55% in the last decade. On the other hand, the proportion of last authors increased from 8.7% to 41.1% in the same period. Most publications with female researchers were from the United States, Canada, Australia, Brazil, the Netherlands, Spain, England, Germany, Sweden, and China. Nine of these countries had over 50% of the articles published by female first authors. However, in all 10 countries, <50% of the articles were published by female last authors. CONCLUSIONS: The proportion of female researchers increased over time. However, regional differences exist and should be addressed in gender equity policies. There is a gap in the participation of female researchers as last authors. By actively addressing the gender gap in research, the global society can harness the full potential of all talented individuals, regardless of gender, leading to more inclusive and impactful scientific advancements.

An Overview of Physical Activity Research Evolution in Africa: The Global Observatory for Physical Activity-GoPA!

OBJECTIVE: To describe the evolution of physical activity (PA) research in Africa, examine income and gender inequalities, and discuss future possibilities. METHODS: A secondary analyses of the Global Observatory for Physical Activity data on PA research in Africa (1950-2019). RESULTS: We identified 514 PA articles from 47 African countries in the past 70 years. Majority (83.1%) of the articles were published between 2012 and 2019. Fifteen countries had no publications. Six countries (South Africa [n = 156], Nigeria [n = 85], Ethiopia [n = 44], Ghana [n = 41], Kenya [n = 39], and Cameroon [n = 20]) accounted for about 75% of the publications. Most articles were observational (92.4%), single-country studies (78.4%), with male first (58.4%) and last authors (68%), and were classified as surveillance studies (45.1%). Few studies addressed interventions (5.8%) and policy (3.5%) or used device-based PA measurement (14.0%). The number of articles per country was positively related to human population level (r = .552, P = .000) and gross domestic product % spent on research and development (r = .301, P = .040). The publication rate per 100,000 people was positively related with the human development index (r = .349, P = .016) and negatively with the gender inequality index (r = -.360, P = .019). CONCLUSIONS: Our results provide an overview and status of PA research in Africa, highlighting country differences and gender inequalities in authorship. The findings may be used to benchmark the evolution of research in the region and to inform areas for improvement. There is an urgent need for more PA interventions and policy studies in Africa.

Role of Pv-aCO2 gradient and Pv-aCO2/Ca-vO2 ratio during cardiac surgery: a retrospective observational study.

INTRODUCTION: Arterial lactate, mixed venous O2 saturation, venous minus arterial CO2 partial pressure (Pv-aCO2) and the ratio between this gradient and the arterial minus venous oxygen content (Pv-aCO2/Ca-vO2) were proposed as markers of tissue hypoperfusion and oxygenation. The main goals were to characterize the determinants of Pv-aCO2 and Pv-aCO2/Ca-vO2, and the interchangeability of the variables calculated from mixed and central venous samples. METHODS: 35 cardiac surgery patients were included. Variables were measured or calculated: after anesthesia induction (T1), end of surgery (T2), and at 6...8.ßhours intervals after ICU admission (T3 and T4). RESULTS: Macrohemodynamics was characterized by increased cardiac index and low systemic vascular resistances after surgery (p.ß<.ß0.05). Hemoglobin, arterial-pH, lactate, and systemic O2 metabolism showed significant changes during the study (p.ß<.ß0.05). Pv-aCO2 remained high and without changes, Pv-aCO2/Ca-vO2 was also high and decreased at T4 (p.ß<.ß0.05). A significant correlation was observed globally and at each time interval, between Pv-aCO2 or Pv-aCO2/Ca-vO2 with factors that may affect the CO2 hemoglobin dissociation. A multilevel linear regression model with Pv-aCO2 and Pv-aCO2/Ca-vO2 as outcome variables showed a significant association for Pv-aCO2 with SvO2, and BE (p.ß<.ß0.05), while Pv-aCO2/Ca-vO2 was significantly associated with Hb, SvO2, and BE (p.ß<.ß0.05) but not with cardiac output. Measurements and calculations from mixed and central venous blood were not interchangeable. CONCLUSIONS: Pv-aCO2 and Pv-aCO2/Ca-vO2 could be influenced by different factors that affect the CO2 dissociation curve, these variables should be considered with caution in cardiac surgery patients. Finally, central venous and mixed values were not interchangeable.

Role of Pv-aCO2 gradient and Pv-aCO2/Ca-vO2 ratio during cardiac surgery: a retrospective observational study

Abstract Introduction: Arterial lactate, mixed venous O2 saturation, venous minus arterial CO2 partial pressure (Pv-aCO2) and the ratio between this gradient and the arterial minus venous oxygen content (Pv-aCO2/Ca-vO2) were proposed as markers of tissue hypoperfusion and oxygenation. The main goals were to characterize the determinants of Pv-aCO2 and Pv-aCO2/Ca-vO2, and the interchangeability of the variables calculated from mixed and central venous samples. Methods: 35 cardiac surgery patients were included. Variables were measured or calculated: after anesthesia induction (T1), end of surgery (T2), and at 6-8 hours intervals after ICU admission (T3 and T4). Results: Macrohemodynamics was characterized by increased cardiac index and low systemic vascular resistances after surgery (p < 0.05). Hemoglobin, arterial-pH, lactate, and systemic O2 metabolism showed significant changes during the study (p < 0.05). Pv-aCO2 remained high and without changes, Pv-aCO2/Ca-vO2 was also high and decreased at T4 (p < 0.05). A significant correlation was observed globally and at each time interval, between Pv-aCO2 or Pv-aCO2/Ca-vO2 with factors that may affect the CO2 hemoglobin dissociation. A multilevel linear regression model with Pv-aCO2 and Pv-aCO2/Ca-vO2 as outcome variables showed a significant association for Pv-aCO2 with SvO2, and BE (p < 0.05), while Pv-aCO2/Ca-vO2 was significantly associated with Hb, SvO2, and BE (p < 0.05) but not with cardiac output. Measurements and calculations from mixed and central venous blood were not interchangeable. Conclusions: Pv-aCO2 and Pv-aCO2/Ca-vO2 could be influenced by different factors that affect the CO2 dissociation curve, these variables should be considered with caution in cardiac surgery patients. Finally, central venous and mixed values were not interchangeable.

Acesso a locais para a prática de atividade física entre usuários de Unidades Básicas de Saúde / Access to places for physical activity among users of Basic Health Units

O objetivo desse estudo foi descrever a prevalência de acesso a locais para a prática de atividade física (AF) por usuários de Unidade Básica de Saúde (UBS) da zona urbana da cidade de Pelotas, Rio Grande do Sul. Foi realizado um estudo de delineamento transversal, de base populacional comunitária, com usuários de 18 anos ou mais, que alguma vez tenham recebido aconselhamento para a prática de AF na UBS e que estivessem aguardando atendimento na sala de espera da UBS. Foram coletadas variáveis socioeconômicas, demográficas, comportamentais, de saúde e de acesso a AF. O desfecho, acesso a algum local para prática de AF, foi operacionalizado pela seguinte pergunta: "Após o aconselhamento para a prática de atividade física, o(a) Sr(a) teve acesso a algum local em que fosse possível realizar atividade física?". Foram entrevistados 248 usuários em 31 UBS visitadas. A prevalência de acesso a locais para a prática de AF foi de 52,8%, sendo os locais públicos os mais acessados (63,4%). Entre quem não teve acesso, 46,2% não procuraram por um local e 29,2% relataram não existir local público adequado. Concluímos que apesar dos usuários de UBS considerarem a AF como importante para a saúde e apesar de ter recebido aconselhamento para a prática de AF, pouco mais da metade dos entrevistados teve acesso a locais de prática de AF

The aim of the study was to describe the prevalence of access to places for physical activity (PA) practice among users of Primary Health Care Unit (PHCU) in the urban area of Pelotas, Rio Grande do Sul. A cross-sec-tional, community-based study was carried out with users aged 18 years or older who had ever received PA counseling at the PHCU and who were in the waiting rooms of the services. Socioeconomic, demographic, behavioral, health and access to PA variables were analyzed. To verify the outcome, access to PA facilities/spaces, we used the following question: "After physical activity counseling, did you had access to some place where you could perform physical activities?". In the 31 PHCU visited, 248 users were interviewed. The prevalence of access to places for PA practice was 52.8%, the public places were the most accessed (63.4%). Among those who did not have access, 46.2% did not look for a place and 29.2% reported that there was no adequate public place. It was concluded that although PHCU users consider PA as important for health and despite having received counseling for PA, just over half of interviewees have access to PA practice places

Oclusión intestinal en una paciente portadora de un Feocromocitoma no diagnosticado. Manejo anestésico / Intestinal occlusion in a patient with an undiagnosed pheochromocytoma. Anesthetic management

El feocromocitoma es un tumor productor de catecolaminas que procede de las células cromafines del sistema nervioso simpático que puede causar hipertensión severa entre otros trastornos sistémicos. Pueden ser esporádicos o encontrarse asociados a varias enfermedades genéticas: neoplasia endocrina múltiple tipo 2, enfermedad de von Hippel-Lindau, neurofibromatosis de tipo 1 y paraganglioma familiar. Cuando un paciente en el que se sospecha la presencia de un feocromocitoma se presenta con una ugencia quirúrgica representa un gran desafío para el anestesiólogo, ya que en esta situación la mortalidad aumenta notablemente. Presentamos el caso de una paciente que resultó ser portadora de un feocromocitoma, integrando un síndrome MEN 2b con masas suprarrenales bilaterales que se presentó en la urgencia con una oclusión intestinal con una crisis hipertensiva severa con edema agudo de pulmón.

Pheochromocytoma is a tumor catecholamine-producing derived from chromaffin cells of the sympathetic nervous system that can cause severe hypertension among other systemic disorders. They may be sporadic or be associated with several genetic diseases: multiple endocrine neoplasia type 2, von Hippel-Lindau, neurofibromatosis type 1 and familial paraganglioma disease. When a patient who is suspected the presence of a pheochromocytoma presents with a surgical urgency represents a great challenge for the anesthesiologist, since in this situation the mortality increases significantly. We report the case of a patient who was found to be carrying a pheochromocytoma, integrating a MEN 2b syndrome with bilateral adrenal masses showed the urgency with bowel obstruction with severe hypertensive crisis with acute pulmonary edema.

Feocromocitoma é um tumor produtor de catecolamina derivada de células cromafins do sistema nervoso simpático que pode causar hipertensão grave entre outros distúrbios sistémicos. Eles podem ser esporádica ou estar associada a várias doenças genéticas: neoplasia endócrina múltipla tipo 2, von Hippel-Lindau, a neurofibromatose tipo 1 e doença paraganglioma familiar. Quando um paciente no qual a presença de um feocromocitoma suspeito apresenta-se com um ugencia cirúrgica representa um grande desafio para o anestesiologista, uma vez que nesta situação os mortalidade aumenta significativamente. Relatamos o caso de um paciente que foi encontrado carregando um feocromocitoma, integrando MEN 2b síndrome com massas adrenais bilaterais mostrou a urgência com obstrução intestinal com crise hipertensiva grave com edema pulmonar agudo.

Análisis de los recursos disponibles para el manejo de la vía aérea en sala de operaciones

RESUMEN Objetivo: determinar los recursos disponibles en las salas de operaciones de nuestro país para manejo de la vía aérea, y qué niveles se alcanzan del algoritmo de vía aérea dificultosa de la Sociedad Americana de Anestesiología (ASA). Se realizó un estudio de corte transversal, documentando en cada sala de operaciones de Montevideo si tenían una bandeja/valija/carro de intubación dificultosa, y todos los dispositivos para intubación, ventilación, supraglóticos, y para abordaje quirúrgico de la vía aérea. Según los niveles alcanzados en el algoritmo de la ASA, los centros quirúrgicos se clasificaron de 1 a 4. Resultados: solo 9/24 centros de adultos alcanzaron los cuatro escalones del algoritmo de la ASA (material para intubación + ventilación + supraglóticos de intubación o fibrobroncoscopio [FBC] + quirúrgico) y 1/19 en niños. seis centros de adultos y cinco pediátricos completaron el tercer escalón (dispositivos intubación + ventilación + supraglóticos de intubación o FBC, ó material quirúrgico). ocho salas de adultos y 11 de niños completaron el segundo escalón (material intubación + ventilación), y una de niños solo llegó al primer escalón. En todos los casos se puede convocar a fibroscopista para la intubación. El conductor estándar y la máscara laríngea están disponibles en todos los centros de adultos. Conclusiones: la mayor parte de los centros quirúrgicos están preparados para manejar adecuadamente la vía aérea prevista mediante la intubación fibróptica, pero en la mayoría los recursos son insuficientes para el abordaje integral de la vía aérea dificultosa o imposible imprevista, según las pautas de la ASA.

SUMMARY Objective: to determine the resources available for airway management in the operating rooms of our country, and the levels reached of the difficult airway algorithm of the American Society of Anesthesiologists (ASA). A transversal cut study was carried out, where it was documented the availability of a difficult intubation tray/bag/cart/ in each operating room of Montevideo, as well as of all necessary intubation, ventilation and supraglottic devices and those required for surgical airway approach. According to the levels of the ASA algorithm reached, surgical centers were classified from 1 to 4. Results: only 9/24 adult centers reached the 4 steps of ASA algorithm (material for intubation + ventilation + airway supraglottic devices or Fiberbronchoscope (FB) + surgical material) and 1/19 in pediatric centers; 6 adult and 5 pediatric centers completed step 3 (intubation + ventilation + airway supraglottic devices or FB, or surgical material); 8 adult rooms and 11 children rooms reached step 2 (intubation + ventilation material), and one pediatric room reached only the first step. In all cases, a fibroscopist may be called for intubation. The standard tube and laryngeal mask are available in all adult centers. Conclusions: most surgical centers are prepared to adequately manage an expected difficult airway through fiberoptic intubation, but, in most cases, resources are insufficient for an integral approach of unexpected difficult or impossible airway, according to ASA guidelines.

RESUMO Objetivo: determinar os recursos disponíveis nas salas de cirurgia de nosso pais para o manejo da via aérea, e que níveis se atingem do algoritmo da via aérea dificil da Sociedade Americana de Anestesiologia (ASA). Realizou-se um estudo de corte transversal, documentando em cada sala de cirurgia de Montevidéu se havia uma bandeja/maleta/carro para intubação dificil, e todos os dispositivos para intubação, ventilação, supragloticos, e para abordagem cirúrgica da via aérea. De acordo com os níveis atingidos no algoritmo da ASA , os centros cirúrgicos foram classificados de 1 a 4. Resultados: somente 9/24 centros de adultos atingiram os 4 degraus do algoritmo da ASA (material para intubação + ventilação + supragloticos de intubação ou fibrobroncoscopio (FBC) + cirúrgico) e 1/19 pediatricos. 6 centros de adultos e 5 pediátricos completaram o terceiro degrau ( dispositivo de intubação + ventilação + supraglotico de intubação e FBC, ou material cirúrgico). 8 salas de adultos e 11 de crianças completaram o segundo degrau (material intubação + ventilação), e uma de criança somente chegou ao primeiro degrau. Em todos os casos se pode convocar fibroscopista para a intubação. O condutor comum e a máscara laríngea estão disponíveis em todos os centros de adultos. Conclusões. A maioria dos centros cirúrgicos estão preparados para lidar adequadamente com a via aérea prevista mediante a intubação fibroptica, mas na maioria deles os recursos são insuficientes para a abordagem integral da via aérea difícil ou impossível imprevista para seguir o protocolo da ASA.

Tratamiento del dolor oncológico con morfina por vía oral y subcutánea / Treatment of oncologic pain with oral and subcutaneous morphine

El objetivo de este trabajo fue evaluar la eficacia del tratamiento del dolor oncológico con opiáceos vía oral y subcutánea y la aparición de efectos colaterales. Se realizó un estudio retrospectivo donde se analizaron 261 pacientes neoplásicos con una edad promedio de 59,70 ± 12,55 años que consultaron en la Unidad de Terapia del Dolor del Servicio de Anestesiología del Hospital Universitario (Hospital de Clínicas).Se realizó una clasificación de las neoplasias según su origen y se documentaron las zonas más frecuentes de aparición del dolor. La terapia se basó en las guías de la Organización Mundial de la Salud (OMS) para el tratamiento del dolor por cáncer (1982). La morfina (licor de Brompton) fue administrada por vía oral o enteral, utilizándose la vía subcutánea en caso de intolerancia digestiva o depresión de conciencia. Se documentaron los siguientes puntos: intensidad del dolor (mediante la Escala Visual Análoga: EVA), cambios en los planes de tratamiento y requerimientos de morfina y presencia de efectos colaterales adversos. Se logró una reducción estadísticamente significativa de los pacientes con dolor severo (EVA: 7-10) al final del tratamiento, así como un aumento estadísticamente significativo (p<0,01) de pacientes analgesiados (EVA: 0) y pacientes con dolor leve (EVA: 1-3). Los pacientes con dolor moderado (EVA: 4-6) registraron también un aumento significativo en su número. Los efectos colaterales más frecuentes fueron aquellos relacionados con el tracto gastrointestinal: náuseas y vómitos (34,4 por ciento) y constipación (31,20 por ciento); se registró depresión de conciencia (1,20 por ciento) y depresión respiratoria (0,6 por ciento) en pacientes con falla renal o hepática o ambas